What is Portal Hypertension?

Portal hypertension is a condition in which the liver does not receive enough blood due to high blood pressure of the portal vein. The portal vein is responsible for guiding blood from the stomach and intestines, where it then breaks into smaller veins. These smaller veins carry blood to the liver, the organ responsible for helping to convert the nutrients from food into energy. If the veins connected to the liver have difficulty transporting blood, the body may form new veins on the stomach and intestines known as varices to help carry the blood more quickly. Varices are thinner than normal veins and more susceptible to bursting and causing internal bleeding.

Mild cases of portal hypertension may not have any noticeable symptoms. As the condition progresses, a person may notice puffiness in his or her midsection. This puffiness is known as ascites and is due to a backup of fluid in the stomach. A person with the condition may also have black vomit or feces, which indicates bleeding of the intestines. In more severe cases, the condition may prevent the body from absorbing protein from food and lead to difficulty concentrating or memory loss, a symptom referred to as encephalopathy.

The majority of portal hypertension cases are due to other disorders or conditions that cause damage to the liver. One of the most common culprits is cirrhosis, a disease that causes the liver to develop hard tissue to replace deteriorated sections of once healthy liver tissue. Cirrhosis is typically due to alcohol abuse, which can cause damage to liver tissue. Other possible causes of portal hypertension are hepatitis C and thrombosis, or blood clots of the portal veins.

Doctors generally recommend changes in diet as a form of treatment for the beginning stages of portal hypertension. Since the condition can cause the liver to not receive as much blood as normal, an affected person may not be able to receive enough nutrients from food. He or she may need to pay special attention to consuming enough nutrient-dense foods in order to counteract the loss of some nutrients the liver may not absorb. A person with the condition may also need to limit his or her sodium intake because high levels of sodium can make ascites worse.

Portal hypertension will also typically need to be treated with medication to help reduce blood pressure. More severe cases of portal hypertension can be treated with surgery to physically reroute the veins leading to the liver. A common surgical treatment procedure is a transjugular intrahepatic portosystemic shunt (TIPS), an operation in which a surgeon attaches the portal vein onto the veins of the liver known as hepatic veins. This procedure helps ensure that blood will reach the liver more easily because they have less of a distance to travel.